COVID-19 has shaken immunization systems and revealed some challenges that affect them. Furthermore, the fear of visiting health facilities because of COVID-19 has been spread between caregivers and health workers in many countries. Simultaneously, the risk of VPDs is increasing with the delay in administrating vaccinations to eligible children. Therefore, if routine immunization is halted, the countries will face outbreaks of VPDs and have the potential to further undermine the already challenged healthcare situation in the region.
On Tuesday, August 11, 2020, and as a continuation of the “Immunization” specific webinars series, EMPHNET conducted a webinar titled “COVID-19 Public Hesitancy and Provider Reluctance, Impact on Immunization Services and Mitigation Measures”, in partnership with US CDC and with the participation of UNICEF/MENARO.
The objective of this webinar is to contribute to experience sharing and capacity building efforts in the region and beyond. It achieves this goal by providing a convening platform of expertise at the global, regional, and country levels for knowledge exchange towards addressing public vaccination hesitancy and provider reluctance in the context of COVID-19.

The webinar was led by three health experts, namely: Behavioral Scientist in the Global Immunization Division at US CDC, DrNeetu Abad; Senior Immunization Specialist for the Middle East and North Africa Regional Office (MENARO), Dr. Daniel Ngemera; and National EPI Manager in Jordan, Dr. Kamel Abusal. The session was facilitated by Health Communication Specialist at US CDC Global Immunization Division, Ms. Elisabeth Wilhelm; and Director of Public Health Programs, Global Health Development Dr. Magid Al-Gunaid.
Dr. Al-Gunaid started the session by giving a brief introduction on the factors influencing immunization uptake. He highlighted the fact that vaccine hesitancy is not new at the global or regional levels, and that immunization is facing a growing challenge of confidence. Dr. Al-Gunaid added that hesitancy is not limited to the beneficiaries, but it also affects some of the providers who also have the same community beliefs. He also reflected on the impact of COVID-19 on immunization and the underlying reasons affecting these impacts. He then presented the speakers and introduced the webinar’s focus.

In her presentation, Dr. Abad explained the factors that influence vaccine-related decision-making. She also explained that vaccine confidence is built on different elements: the health system, the vaccinator, and the vaccine itself. She then stated the promising interventions that can help reduce the negative impact of COVID-19 based on the documented countries’ experiences, namely: strengthening community engagement techniques, increasing Health care workers’ (HCW) capacity to communicate about vaccines to caregivers, and responding to vaccine misinformation to increase public trust.

The second presenter, Dr. Ngemera, raised the concern that countries are battling the VPDs outbreak while responding to COVID-19. He highlighted the new guidelines that need to be adopted at the national level and mentioned some successes despite the pandemic situation in the region. These successes include conducting multi-antigen campaigns in Syria, and diphtheria and polio campaign in Yemen. Dr. Ngemera then recommended four areas of work namely: resumption of services and implementation of the postponed campaign, demand interventions, documentation of lessons learned from countries, and strengthening coordination among partners at regional and country levels.

The third presenter, Dr. Abusal, gave a brief background on the immunization program in Jordan and its achievement before COVID-19. He explained that some of the procedures that the government implemented to prevent COVID19 transmission resulted in health services disruption, including a decrease in immunization coverage. He also highlighted Jordan’s immunization program interventions to mitigate the impact of COVID-19. Dr. Abusal then summarized the challenges facing the program among refugees, and he ended his presentation by recommending a formal process to assess vaccine hesitancy in Jordan.
Two hundred sixty-sixpersons attended the webinar. After the presentations, a Q&A session was facilitated by Ms. Wilhelm.